Individual
LACY GARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
111 S ALABAMA AVE, OKMULGEE, OK 74447-5038
(918) 756-2800
Mailing address
111 S ALABAMA AVE, OKMULGEE, OK 74447-5038
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F09191574
OK
Other
Enumeration date
11/06/2019
Last updated
11/06/2019
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